UH - Managed Care Office

Office of Managed Care Operations

PHYSICIAN HEALTHCARE SERVICES

	Quick Reference Guide
	Telephone Guide
	Claims Address
	Physician Healthcare Services Website (This link is provided for the convenience of our website visitors. UMDNJ University Hospital takes no responsibility for the information or proprietary of the web sites listed above.)

PHYSICIAN HEALTHCARE PLAN OF NJQUICK REFERENCE GUIDE

Facility/Provider # 221775306

ELECTIVE	REQUIREMENTS
INPATIENT ADMISSION	Authorization Required by Patient, Admitting Physician, or Hospital
SAME DAY SURGERY	Authorization Required by Patient, Admitting Physician, or Hospital
OUT PATIENT PROCEDURE	Authorization Required by Patient, Admitting Physician or Hospital

NOTE: Patient must call to obtain authorization @ 1-800-237-4765 (precertification). Hospital Admitting Department must call Physician Healthcare prior to admission or surgery to make sure admission or surgery has been authorized.

EMERGENCY/DIRECT

EMERGENCY ROOM VISIT	No Authorization or Notification Required
EMERGENCY ADMISSION	Authorization Required. Notification required within 24-hr or next business day, by Patient, Family Member, or Hospital.
DIRECT ADMISSION	Authorization Required Notification required within 24-hr or next business day, by Patient, Family Member, Physician, or Hospital
MENTAL HEALTH/ADMISSION & SUBSTANCE ABUSE	See note below
NON MENTAL HEALTH & SUBSTANCE ABUSE	See note below

NOTE: For All Mental Health & Substance Abuse Admission must call Creative Intervention @ 1-800-771-1187 for authorization for admission.

PHYSICIAN HEALTHCARE PLAN OF NJ

Quick Reference Guide

Referral/Pre-Auth. Requirements for Outpatient Services

REFERRAL REQUIRED-OUTPATIENT

PRE AUTHORIZATION REQUIRED-

OUTPATIENT

Specialist Visit

MRI

CT Scan

Rehab

Mental Health Svcs.

Therapy PT/RT/OT/ Speech

Radiation Therapy

Chem Depend

Radiation Therapy

Oral Surgery

NOTE: For all Audiology Svcs. & Dialysis Please call Provider Relations @ 1-800-977-4765 prior to services.

PHYSICIAN HEALTHCARE PLAN OF NJ TELEPHONE GUIDE

Provider Representative, Jenny Lewandowski	609-896-1233 X160
Benefits Department	1-800-977-4765
Precert Department	1-800-237-4765
Member Service	609-396-9400 X162

PHYSICIAN HEALTHCARE CLAIMS ADDRESS

PHYSICIAN HEALTHCARE PLAN OF NJ

P.O. BOX 5265

PRINCETON, NJ 08543

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University Hospital | UMDNJ | NJMS | NJ Med PC

University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300